Table 1.

Japanese severity scoring system for acute pancreatitis of the Ministry of Health, Labour, and Welfare of Japan (2008 revision)

Prognostic factors (one point for each factor)	CT grade based on contrast‐enhanced CT
Base excess ≦−3 mEq/L or shock (systolic blood pressure <80 mmHg) PaO2 ≦ 60 mmHg (room air) or respiratory failure (respiratory assistance needed) BUN ≧ 40 mg/dL or (or creatinine ≧ 2.0 mg/dL) or oliguria (daily urine output <400 mL even after intravenous fluid resuscitation) LDH ≧ twice upper limit of normal Platelet count ≦ 100 000/mm3 Serum Ca ≦ 7.5 mg/dL CRP ≧ 15 mg/dL Number of positive measures in SIRS criteria ≧3 Age ≧ 70 years	Extrapancreatic progression of inflammation Anterior pararenal space, 0 point Root of mesocolon, 1 point Beyond lower pole of kidney, 2 points 2. Hypoenhanced lesion of the pancreas The pancreas is conveniently divided into three segments (head, body, and tail) Localized in each segment or only surrounding the pancreas, 0 point Extends to 2 segments, 1 point Occupies 2 whole segments or more, 2 points 1 + 2 = total score Total score = 0 or 1, Grade 1 Total score = 2, Grade 2 Total score = 3 or more, Grade 3
Assessment of severity If prognostic factor score is ≧3, or CT grade is ≧2, the acute pancreatitis is evaluated as ‘severe’

Measures in SIRS criteria include body temperature >38 or <36°C, heart rate >90 beats/min, respiratory rate >20 breaths/min or PaCO₂ <32 torr, and white blood cell counts >12 000 cells/mm³, <4000 cells/mm³, or >10% immature (band) forms.

BUN, blood urea nitrogen; CRP, C‐reactive protein; CT, computed tomography; LDH; lactate dehydrogenase, SIRS, systemic inflammatory response syndrome.